title: Diagnosis of desmoplastic reaction by immunohistochemical analysis, in biopsy specimens of early colorectal carcinomas, is efficacious in estimating the depth of invasion.
abstract: The aim of our study was to evaluate the diagnosis of desmoplastic reaction (DR) by immunostaining for α-smooth muscle actin (αSMA) and desmin, for predicting the depth of submucosal invasion in biopsy specimens of early colorectal carcinomas (CRCs). Thirty-eight cases of non-pedunculated early CRCs were included in this study. Positive for DR was defined as αSMA-positive and desmin-negative stroma in the CRC. The depth of submucosal invasion was measured in endoscopically or surgically resected specimens and the lesions were subsequently divided into two groups: Group A (carcinoma in situ/intramucosal carcinoma and submucosal invasive carcinoma with a depth <1000 μm) and Group B (submucosal invasion with a depth ≥1000 μm). Twenty-one cases were DR-positive and 17 were DR-negative. No statistical significance was found between the DR with regard to tumor size, location and histological type. All DR-positive cases belonged to Group B whereas 14 (82.4%) DR-negative lesions belonged to Group A (p < 0.001). The sensitivity, speciﬁcity, positive and negative predictive values and accuracy of DR positivity for diagnosis of Group B were 87.5%, 100%, 100%, 82.4% and 92.1%, respectively. Conclusively, detection of DR in biopsy specimens with ancillary immunohistochemistry (αSMA/desmin) would help in preoperative diagnosis for the depth of submucosal invasion of early CRC.
authors.affiliation: Department of Surgical and Molecular Pathology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan. hmitomi@dokkyomed.ac.jp.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Ohno
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fujimori
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Ichikawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Johji
authors.initials: J
authors.lastname: Imura
authors.forename: Shigeki
authors.initials: S
authors.lastname: Tomita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Mitomi
mesh_terms: D001706:Biopsy; D002277:Carcinoma; D015179:Colorectal Neoplasms; D006801:Humans; D007150:Immunohistochemistry; D009361:Neoplasm Invasiveness